مجله دانشکده پزشکی اصفهان
پیاپی 563 (هفته سوم فروردین 1399)

Obesity and its related morbidities has become a great concern worldwide. Bariatric surgery, regardless of its type, is the most effective approach for morbid obesity treatment. Single anastomosis sleeve jejunal (SASJ) bypass is a novel technique of bariatric surgery that can be considered for patients with previous history of severe gastroesophageal symptoms. The current study aimed to compare outcomes of SASJ with classic gastric bypass in a six-month follow-up.

This was a cohort study conducted on 50 patients underwent two types of bariatric surgeries (Classic Roux en-Y and SASJ), each contained 25 cases, during the years 2017 and 2018. Patients' information including age, gender, height, basal weight, body mass index (BMI), serum albumin, and glycated hemoglobin (HbA1C) were recorded and compared basically and within one, three and six months after surgery.

Members of two groups were similar regarding age, gender distribution, height, basic BMI, HbA1C, albumin, and excess weight (P > 0.050 for all). Both the groups significantly lost weight within six months; while comparison of them showed no statistical difference regarding excess weight loss, BMI, HbA1C, and albumin (P > 0.050 for all). Within six months, the mean excess weight loss was 54.54 in SASJ and 50.54 in the other group.

Trend of weight loss following SASJ bypass was similar to classic gastric bypass. Therefore, due to reversibility and easier gastric follow-up studies in SASJ approach, this technique can be considered for cases with particular indications. Further studies with longer follow-ups are strongly recommended.

Acute diarrhea is one of the most important health issues in developing countries. Yogurt drink (Dough) is used in home remedies and some medical advice as a useful ingredient in treating dehydration and diarrhea; but no controlled studies have been conducted in this regard. The aim of this study was to compare the effect of fluid therapy along with dough or yogurt in the treatment of acute diarrhea in children.

In this randomized clinical trial study, 210 children aged 1-5 years with acute diarrhea, who were admitted to Taleghani hospital in Gorgan, Iran, were entered. The first group received low-fat yogurt, and the second group received dough, which the volume was three times the volume of yogurt in the first group. The third group was control group. Standard fluid therapy groups had done for all patients. Decrease in diarrhea frequency and hospitalization in these three groups were compared.

The highest reduction in diarrhea was in yogurt group with an average of 6.144, and the lowest in dough group with a mean of 5.344 (P = 0.108). After controlling the effect of the severity of the disease, the dough-receiving group had the longest hospitalization time, and this difference was significant.

The results of this study showed that the use of dough and yogurt, along with fluid therapy, did not reduce the frequency of acute diarrhea and duration of admission in children under five years of age. Further research with higher sample sizes and the implicating probiotic drinks along with dough seems necessary. Due to the small number of studies in this issue and the result of the present study, at present dough cannot be recommended as an effective agent in the treatment of diarrhea.

Systemic or intralesional injection of Glucantime in treatment of cutaneous leishmaniasis, sometimes leads to a local allergic reaction. This study aimed to evaluate the effect of local allergic reaction to intralesional Glucantime on recovery course of cutaneous leishmaniasis.

In a retrospective cross-sectional study, the data of patient records of cases with cutaneous leishmaniasis, who underwent local treatment with Glucantime in Imam Reza dermatology clinic, Mashhad, Iran, from March 2006 to March 2011, were evaluated. All cases that showed a localized allergic reaction to Glucantime were selected as the case group and the cases of cutaneous leishmaniasis without any allergic reaction to treatment were selected as control group. Patients were evaluated in subsequent follow-up periods for improvement after Glucantime injection.

The mean number of injections needed for complete recovery was 6.54± 3.76 in patients with topical allergic reaction and 9.77 ± 5.14 in control group; there was a statistically significant difference between two groups (P = 0.002). The time to complete recovery in patients with topical allergic reaction to Glucantime was insignificantly shorter.

This study showed that patients with local allergic reaction to Glucantime require fewer numbers of injections to achieve complete recovery than non-allergic patients